Why Company Lawyers Are Reading a Mental-Health Manual

The fifth edition of the Diagnostic and Statistical Manual, or DSM-5, of the American Psychiatric Association has some unexpected readers: employment lawyers, who want to know how the updated manual will affect disability issues in the workplace.

AP

The latest version of the American Psychiatric Association’s guidebook of mental disorders is the manual’s first major update in nearly 20 years.

The manual, the primary reference for mental-health diagnoses, was released in May and adds several new conditions to the family of recognized mental illnesses.

Those new conditions help psychiatrists be more precise in identifying and treating disorders. They also open the door to more requests for accommodation under the Americans with Disabilities Act, possible grounds for discrimination lawsuits, and people leaving the workforce with Social Security disability benefits, said James McDonald, a partner with management-side employment firm Fisher & Phillips LLP.

“The mental health community needs to have common definitions for basic mental disorder, but the diagnoses tend to expand with social and cultural changes, and some of the new ones are going to be particularly troublesome in an employment context,” he said.

Among the changes are new diagnoses such as Social (Pragmatic) Communication Disorder, which relates to difficulty interacting with others, and Mild Neurocognitive Disorder, which refers to memory problems. The manual also loosens some of the criteria for previous diagnoses such as Post-Traumatic Stress Disorder and Major Depressive Disorder.

Social (Pragmatic) Communication Disorder, known as SCD in the manual, covers people who are not on the autistic spectrum but have significant problems with verbal and nonverbal communication, which impairs their ability to “perform academically or occupationally,” according to the DSM-5.

People previously considered quirky or shy may now qualify for this diagnosis, said Mr. McDonald. For employers, “finding the right accommodations can be a challenge.”

Employers aren’t required to eliminate essential functions of a job or lower quality or quantity expectations, so an employee in sales could not ask for a lower sales quota. But he or she could request a modification of his work schedule, hours, or supervision, McDonald said.

The new manual presents the first opportunity to see how employers will update their approaches to a new set of mental-health diagnoses. The last version was released in 1994, at around the same time the ADA went into effect. McDonald said he is not aware of any lawsuits yet filed using the new diagnoses.

Mental illness causes significant pain in both economic terms and the suffering of individuals and their families. The World Economic Forum estimates that the global cost of mental illnesses in 2010 was $2.5 trillion, in direct outlays for treatment as well as the indirect toll of work absences and other forms of lost productivity, and will rise to $6 trillion in 2030.

About At Work

Written and edited by The Wall Street Journal’s Management & Careers group, At Work covers life on the job, from getting ahead to managing staff to finding passion and purpose in the office. Tips, questions? email us.